Please Pay for Your Trip Here

Donation Amount*
  • Student Trip $900
  • Education/Comm Dev Trip $900
  • Medical Trip $1200
  • Two Medical Trips $2400
  • Two Student/Education/Comm Dev Trips $1800
  • Other $

Contact Information

Country*
State / Province*
Address*
City*
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Email*
Confirm Email*
Phone*

Payment Information

Amount*
$
Name on Card*
Card Number*
Additional Comments

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